1. Arterial and venous thrombosis in coronavirus 2019 disease (Covid-19):relationship with mortality
- Author
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Violi, F., Ceccarelli, G., Cangemi, R., Cipollone, F., D'Ardes, D., Oliva, A., Pirro, M., Rocco, M., Alessandri, F., D'Ettorre, G., Lichtner, M., Pignatelli, P., Ferro, D., Ruberto, F., Lip, G. Y. H., Pugliese, F., Mastroianni, C. M., Albante, A., Auricchio, D., De Lazzaro, F., M. De Lauri D., Di Santo, C., Ianni, S., Magnanimi, E., Ratini, F., Sabani, A., Titi, L., Vaccaro, P., Giordano, G., Manganelli, C., Mancone, M., Bruno, K., Celli, P., Consolo, S., Croce, C., Giannetti, L., Martelli, S., Messina, T., Pattelli, E., Perrella, S., Portieri, M., Ricci, C., Almenrader, N., Arzilla, R., Delia, E., Di Giovanni, C., Laderchi, A., Macri, C., Marandola, M., Nardecchia, G., Pacilli, M., Pacini, F., Araimo Morselli, F., Imperiale, C., Tordiglione, P., Ciardi, M. R., Ajassa, C., D'Agostino, C., Russo, G., Trinchieri, V., Guariglia, P., Antonelli, L., Cuomo, R. M., Carnevalini, M., Mastropietro, C., Iaiani, G., Mezzaroma, I., Falciano, M., Brogi, A., Celani, L., Cavallari, N. E., Rivano Capparuccia, M., Massetti, A. P., Fimiani, C., Santori, M., Bianchi, A., Franchi, C., De Angelis, M., Sereno, S., Furlan, C., De Sanctis, G., Paoletti, F., Pasculli, P., Cogliati Dezza, F., Vassalini, P., Cancelli, F., De Girolamo, G., Savelloni, G., Valeri, S., Siccardi, G., Alessi, F., Recchia, G., Ridolfi, M., Romani, F. E., Aronica, R., Filippi, V., Vera, M., Volpicelli, L., Candy, M., Alban, R., Di Bari, S., Gavaruzzi, F., Casali, E., Carli, M. S., Zingaropoli, A. M., Perri, V., Santinelli, L., Pinacchio, C., Nijhawan, P., Miele, C. M., Innocenti, P. G., and Mengoni, F.
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Male ,covid-19 ,mortality ,sars-cov-2 ,thrombosis ,Coronary Artery Disease ,Kaplan-Meier Estimate ,030204 cardiovascular system & hematology ,law.invention ,Coronary artery disease ,0302 clinical medicine ,law ,80 and over ,Coronary Artery Disease/epidemiology ,Odds Ratio ,SARS-cov-2 ,030212 general & internal medicine ,Prospective Studies ,Aged, 80 and over ,Thromboembolism/epidemiology ,biology ,Hazard ratio ,Middle Aged ,Mortality/trends ,Intensive care unit ,Thrombosis ,Venous thrombosis ,Intensive Care Units ,C-Reactive Protein ,Emergency Medicine ,Cardiology ,COVID-19/complications ,Female ,medicine.medical_specialty ,Fibrin Fibrinogen Degradation Products/analysis ,Fibrin Fibrinogen Degradation Products ,03 medical and health sciences ,C-Reactive Protein/analysis ,Internal medicine ,Thromboembolism ,Internal Medicine ,medicine ,Humans ,Mortality ,Aged ,Proportional Hazards Models ,Intensive Care Units/organization & administration ,business.industry ,C-reactive protein ,COVID-19 ,Odds ratio ,medicine.disease ,Im - Original ,Logistic Models ,Heart failure ,biology.protein ,business - Abstract
Background Patients with coronavirus disease 2019 (Covid-19) may experience venous thrombosis while data regarding arterial thrombosis are sparse. Methods Prospective multicenter study in 5 hospitals including 373 patients with Covid-19-related pneumonia. Demographic data, laboratory findings including coagulation tests and comorbidities were reported. During the follow-up any arterial or venous thrombotic events and death were registered. Results Among 373 patients, 75 (20%) had a thrombotic event and 75 (20%) died. Thrombotic events included 41 venous thromboembolism and 34 arterial thrombosis. Age, cardiovascular disease, intensive care unit treatment, white blood cells, D-dimer, albumin and troponin blood levels were associated with thrombotic events. In a multivariable regression logistic model, intensive care unit treatment (Odds Ratio [OR]: 6.0; 95% Confidence Interval [CI] 2.8–12.6; p p = 0.022); and albumin levels (OR: 0.49; 95% CI 0.28–0.87; p = 0.014) were associated with ischemic events. Age, sex, chronic obstructive pulmonary disease, diabetes, heart failure, coronary heart disease, intensive care unit treatment, in-hospital thrombotic events, D-dimer, C-reactive protein, troponin, and albumin levels were associated with mortality. A multivariable Cox regression analysis showed that in-hospital thrombotic events (hazard ratio [HR]: 2.72; 95% CI 1.59–4.65; p p = 0.001), and albumin (HR: 0.447; 95% CI 0.277–0.723; p = 0.001) predicted morality. Conclusions Covid-19 patients experience an equipollent rate of venous and arterial thrombotic events, that are associated with poor survival. Early identification and appropriate treatment of Covid-19 patients at risk of thrombosis may improve prognosis.
- Published
- 2021
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